Arranging an appointment

How do I arrange an appointment?

To arrange an appointment with Mr Tibrewal, please call the hospital or clinic you wish to be seen at directly or book online using the contact details provided in the Locations section of the website. If you are having difficulty then please do get in touch with us either by phone or email.

Do I need a referral letter?

If you are claiming through your health insurance, they may require a GP referral before authorising your consultation and treatment. Please call if you are unsure and our team will be able to guide you.

If you are paying for treatment yourself then you do not need a referral letter.

Do I need a new or follow-up appointment?

If you have not seen Mr Tibrewal previously for this problem, if you are returning with a different problem or if it is more than 1 year since your last appointment then please book a new appointment.

How much does it cost?

Mr Tibrewal is fee assured and recognised by all the major health insurers. In most cases all outpatient costs should be covered by your insurance, but please check with your insurance company prior to your appointment.

If you are paying for yourself, new appointments will not exceed £300 and follow up appointments will not exceed £200.

How can I be sure that my insurance will cover me?

If you have private medical insurance, please contact your insurer to confirm that you are covered for your consultation and imaging appointments and whether you will need a GP referral. Please do this prior to seeing Mr Tibrewal. Your insurance company will provide you with an authorisation code which we will need when booking your appointment, along with your policy or membership number. Please bring your pre-authorisation code for your consultation and/or treatment, along with your policy or membership number. All of this information can be obtained from your insurance company.

What happens if I have an overseas insurer or live overseas?

If you are insured through an overseas insurer, you will need to pay in advance of your appointment and then claim the cost back from your insurance company.

If you live overseas and are paying for yourself, you will be required to pay in full before your appointment or any treatment.

What happens if I am sponsored by an embassy?

Embassy or sponsored patients should provide a letter of guarantee (LOG) in advance of each appointment. This letter should be presented on official letterhead, stating who is responsible for their consultation and treatment and where the invoice needs to be directed. Without a letter of guarantee, patients will be asked to settle their own account on the day prior to seeing the Consultant. If surgery is required, this will need to be paid for in full prior to admission.



At the appointment

Is there disabled access?

All of the hospitals that Mr Tibrewal uses have disabled access. If you have specific requirements, please call the hospital in advance and they will assist you with your plans.

Is a translator available?

It is very important that you are able to communicate with Mr Tibrewal effectively at the time of your consultation. We can arrange for a translator to be present either on the telephone or in person. Please let us know at least 72 hours in advance of your appointment. You will be responsible for the costs of the translator provided.

Is there parking?

All of the Essex hospitals have parking for patients on site.

Parking in London is very difficult. Please refer to the website of the hospital you are attending for details of local parking options.

If you choose to arrive by public transport or taxi; please ensure you leave enough time to incorporate any delays that may occur.

What do I need to bring?

  • Details of your insurer and any pre-authorisation numbers
  • Details of previous medical treatments.
  • A list of any medications you take regularly
  • Copies of any scans or X rays you have had on the joint of interest.

What should I wear?

You are likely to require an examination. We therefore recommend you wear clothes that are loose or easy to remove. Gowns will be provided for you if needed.

What will happen at the appointment?

Your consultant will ask you a number of questions regarding your problem, and your previous medical history. This will be followed by a physical examination. Depending on the findings, it may be necessary to organise further tests which may include (but not be limited to) X rays, MRI and/or CT scans, ultrasounds or blood tests. Once all the information has been gathered, your Consultant will discuss your diagnosis and the options for treatment with you.

Are chaperones available?

Yes. Please let the nursing staff know on your arrival if you require a chaperone.

Will I need a follow-up appointment?

If further tests are organised, typically an appointment will be organised to go through the results with you.

If you have had an operation, you will have a follow up appointment made for you.

How do I cancel or re-arrange an appointment?

It is very important to let us know in advance if you are unable to make your appointment so that we can allocate your slot to another patient. You can do this directly with the hospital appointments team. If you have any difficulty please contact us.



Investigations (blood tests, x-rays, scans)

When will I have my investigation?

Availability of investigations varies between hospitals and clinics. Some may be completed on the same day, whilst others may require you to re-attend.

What types of investigation are there?

X-rays – These are used for assessment of bones and joints. X-rays involve exposure to a small amount of radiation, if you are pregnant or could be pregnant it is important that you let us know as it may be safer to delay the investigation.

Ultrasound – These scans are performed by a radiologist or radiographer to assess soft tissues. They may also be used to help guide the placement of injections into a joint or around a soft tissue.

CT scan – These scans are predominantly used for looking at bones or an implant. They provide more information than x-rays but require more radiation to achieve this. If you are pregnant or could be pregnant it is important that you let us know as it may be safer to delay the investigation.

MRI scan – These scans use powerful magnets to produce an image of bones and joints. No radiation is required but if you have certain types of metal objects in your body it may not be possible to have a MRI scan. You will be asked to fill in a safety questionnaire before you undergo an MRI scan.

Blood tests – These tests are performed to look for evidence of infection and inflammation. They are also required before larger operations to ensure you are fit for the procedure and to check your blood group.

When will I get my results?

If performed in advance, X-rays can usually be reviewed by your Consultant during your consultation. Scans (ultrasound, MRI and CT) will be reviewed by an imaging specialist (radiologist) and a report sent to your consultant. The report may take up to a week dependent up on the availability of the imaging specialist. Mr Tibrewal will endeavour to see you as soon as possible after requesting a scan to discuss the results and plan treatment.



Arranging an operation

How do I arrange the operation date?

Mr Tibrewal may be able to discuss potential operation dates with you at the time of your appointment. You will receive a call from us following your consultation to discuss and confirm a date that is convenient for you.

What is a pre-operative assessment

Your safety at the time of operation is our utmost priority. Pre-operative assessment is important to determine your suitability for anaesthetic and to optimise your health in advance. Most patients over the age of 50 or those with significant pre-existing medical conditions will require pre-operative assessment. You will receive a call from a nurse to arrange your pre-operative assessment clinic appointment. Typically, a heart tracing (ECG), blood tests, urine tests and swabs to exclude the presence of MRSA will be performed. The nurse will also review your medications. You may be required to see the Anaesthetist in person.

How do I change the date of an operation?

Please call us on 020 3642 9095 as soon as possible. This will allow your operation slot to be reallocated to another patient.

Who will be my anaesthetist?

Mr Tibrewal works with highly experienced anaesthetists at each of the hospitals. You will meet your anaesthetist on the day of the procedure.

How do I find out the cost of an operation?

If you are self-funding your operation then we will provide you with a formal quote prior to your admission. The quote will include hospital fees (including any equipment and implants), surgeon fees and anaesthetic fees and will cover the period of your inpatient care only. Please note that our surgeon fees are fixed and reviewed on a yearly basis, however hospital costs can vary between sites.



If you require an operation

What do I need to do before an operation?

For larger operations or procedures requiring a general anaesthetic you will need to be seen by the pre-assessment team in advance of your surgery date. For joint replacement surgery you may be provided with anti-bacterial soap to use prior to surgery. For inpatient stays, we would recommend you prepare a bag with night clothes, easy fitting day clothes, spare underwear, toiletries and favourite snacks for your stay. If you are undergoing a general anaesthetic you should not eat for 6 hours before surgery. This includes chewing gum, milky drinks and sweets. You can drink clear water normally up to two hours before your operation, with small sips of water up to the time that the operation starts. If you take regular medication, the pre-assessment team will discuss with you which ones you should take on the days before and the day of your operation.

When will I sign a consent form?

In most cases, Mr Tibrewal will have discussed the alternative options to surgery, the advantages of the operation and the risks during your consultation. A consent form detailing these will be signed in the outpatient clinic prior to the operation.



In hospital

What is day-case surgery?

Increasingly, orthopaedic operations are able to be performed as day cases. This includes arthroscopic surgery, ligament reconstruction and in some cases joint replacements. This is due to advances in surgical techniques, anaesthetic and pain control strategies. It means that you may not be required to stay overnight in hospital following your operation. Many patients prefer this option as it means you can sleep in your own bed and use your own bathroom at home. You will take the same medications at home as you would in hospital. Studies show that patients have a greater satisfaction with their recovery when it is done at home. Please do not hesitate to ask Mr Tibrewal if your operation can be done as a day-case.

What will happen whilst I am in hospital?

Upon arrival in the hospital you will be shown to your room. The nursing staff will check you in and complete some paperwork with you. You will be asked to change into a hospital gown and to wear specialist compression stockings on your legs. Mr Tibrewal will visit you in your room to answer any questions you may have. The site of surgery will be marked with a pen. You will be asked to re-sign your consent form. The anaesthetist will go through the details of the anaesthetic with you and answer your questions. Once all the checks have been performed you will be escorted to the operating theatre complex. Following surgery, you will be transferred to a recovery ward prior to returning to your room. Later in the day following the operation you will be seen by the physiotherapy team who will guide you on the next steps.

When can I go home?

You will be able to go home once you have passed all the requirements of the physiotherapist. You will not be advised to go home until the team are satisfied that you will be safe. Any additional help that you will need at home will be organised prior to your discharge. You will be given some medications to take at home as well as instructions for the early phases of your recovery.



After leaving hospital

Where do I have my stitches/clips removed?

Mr Tibrewal will let you know when this should occur. In most cases this can be performed in the hospital in which you had surgery or at your GP.

When will I be seen again by my surgeon?

Mr Tibrewal will discuss with you when your first post-operative appointment should be.

If I need physiotherapy, who do I contact?

Mr Tibrewal will be happy to offer recommendations on physiotherapists to aid your rehabilitation after surgery.

  • The General Medical Council
  • The British Medical Association (BMA)
  • NHS website
  • The Royal College of Surgeons of England
  • British Orthopaedic Association
  • British Association for Surgery of the Knee
  • European Society for Sports Traumatology, Knee Surgery and Arthroscopy
  • American Academy of Orthopaedic Surgeons
  • Top Doctors
  • Percival Pott Club
  • Magellan Orthopaedic Society